What are the responsibilities and job description for the Financial Care Counselor-Commitment Bonus position at Duke University Health System?
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Occ Summary
Accurately complete patient accounts by departmental protocols, policies, and procedures, ensuring compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services. Arrange payment options with the patients and screen patients for government funding sources.
Work Performed
Analyze insurance coverage and benefits for services to ensure timely reimbursement. Obtain all prior authorization certification and/or authorization as appropriate. Facilitate payment sources for uninsured patients. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections and denials promptly and efficiently. Calculate and collect cash payments appropriately for all patients. Reconcile daily cash deposits. Evaluate diagnoses to ensure compliance with the local Medicare review policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes.
Explain bills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine the necessity of third-party sponsorship and process patients by policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's financial hardship. Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level. Update the billing system to reflect the insurance status of the patient. Refer patients to the manufacturer's drug program as needed for medications. Greet and assist visitors and patients. Explains policies and procedures and resolves problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Document the billing system according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.
Considerations Specific to Duke Fertility Center
This vital role will help patients on their journey to parenthood by providing accurate and thorough financial responsibility information ahead of the money due date. Our financial team has protected/templated time with patients to answer questions and ensure the accuracy of their personalized monies owed. The financial care counselor will call insurance companies to obtain benefit information and ensure all criteria are met for prior authorization. They will ensure that the nursing and provider teams are aware when a patient is financially cleared to proceed by participating in our fertility-specific electronic medical record system that is interfaced with Epic. This role will work with many different departments across the health system and externally to Duke. We will provide extensive on-site training for this important role.
This position must participate in a weekend rotation with an 8-hour comp day during the week prior to the weekend. This is subject to change based on staffing.
Knowledge, Skills, Abilities
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.
Level Characteristics
Position responsible for high production generated accurately by established business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently.
Minimum Qualifications
Duke is an affirmative action/equal opportunity employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
Education
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of the related business.
Experience
Two years of experience working in hospital service access, clinical service access, a physician's office, or billing and collections. Or, an associate's degree in a healthcare-related field and one year of experience working with the public. Or, a bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
None required
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Occ Summary
Accurately complete patient accounts by departmental protocols, policies, and procedures, ensuring compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services. Arrange payment options with the patients and screen patients for government funding sources.
Work Performed
Analyze insurance coverage and benefits for services to ensure timely reimbursement. Obtain all prior authorization certification and/or authorization as appropriate. Facilitate payment sources for uninsured patients. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections and denials promptly and efficiently. Calculate and collect cash payments appropriately for all patients. Reconcile daily cash deposits. Evaluate diagnoses to ensure compliance with the local Medicare review policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes.
Explain bills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine the necessity of third-party sponsorship and process patients by policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's financial hardship. Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level. Update the billing system to reflect the insurance status of the patient. Refer patients to the manufacturer's drug program as needed for medications. Greet and assist visitors and patients. Explains policies and procedures and resolves problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Document the billing system according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.
Considerations Specific to Duke Fertility Center
This vital role will help patients on their journey to parenthood by providing accurate and thorough financial responsibility information ahead of the money due date. Our financial team has protected/templated time with patients to answer questions and ensure the accuracy of their personalized monies owed. The financial care counselor will call insurance companies to obtain benefit information and ensure all criteria are met for prior authorization. They will ensure that the nursing and provider teams are aware when a patient is financially cleared to proceed by participating in our fertility-specific electronic medical record system that is interfaced with Epic. This role will work with many different departments across the health system and externally to Duke. We will provide extensive on-site training for this important role.
This position must participate in a weekend rotation with an 8-hour comp day during the week prior to the weekend. This is subject to change based on staffing.
Knowledge, Skills, Abilities
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.
Level Characteristics
Position responsible for high production generated accurately by established business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently.
Minimum Qualifications
Duke is an affirmative action/equal opportunity employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
Education
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of the related business.
Experience
Two years of experience working in hospital service access, clinical service access, a physician's office, or billing and collections. Or, an associate's degree in a healthcare-related field and one year of experience working with the public. Or, a bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
None required
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
